Provider Demographics
NPI:1760574875
Name:MCWILLIAMS, SEAN GRAY (DC)
Entity Type:Individual
Prefix:DR
First Name:SEAN
Middle Name:GRAY
Last Name:MCWILLIAMS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:11800 NORTHFALL LN STE 1401
Mailing Address - Street 2:
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30009-7976
Mailing Address - Country:US
Mailing Address - Phone:770-998-1414
Mailing Address - Fax:770-998-1470
Practice Address - Street 1:11800 NORTHFALL LN STE 1401
Practice Address - Street 2:
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30009-7976
Practice Address - Country:US
Practice Address - Phone:770-998-1414
Practice Address - Fax:770-998-1470
Is Sole Proprietor?:No
Enumeration Date:2006-09-28
Last Update Date:2018-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA005642111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAU85099Medicare UPIN